Gulledge Chiropractic P.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038-006606 Issued in IL

Legal business name

GULLEDGE CHIROPRACTIC P.C.

Practice address

477 S Weber Rd
Bolingbrook, IL 60490-5504

Phone

(630) 390-8074

NPI assigned

Oct 3, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Brian Lynn Gulledge, D.C.

Title

Chiropractor

Phone

(630) 390-8074

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1222992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222992000000",
    "number": "1073764437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "477 S WEBER RD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604905504",
            "telephone_number": "630-390-8074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "477 S WEBER RD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604905504",
            "telephone_number": "630-390-8074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULLEDGE CHIROPRACTIC P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-03",
        "last_updated": "2008-10-03",
        "status": "A",
        "authorized_official_last_name": "GULLEDGE",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "630-390-8074",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-006606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Bolingbrook, IL
• Providers in Bolingbrook, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.